ECZEMA
Eczema, also known as dermatitis, is inflammation of the skin. It is common, affecting about 1 in 5 people at some stage in their life. Most cases of eczema are genetic. Atopic dermatitis and affected individuals may also suffer from asthma and /or hay fever or have a family history. This form of eczema is especially common in children and can range from a few mild patches to a more widespread, inflamed (red), itchy rash which results in sleepless nights for both parents and child. It is estimated that around 75% of children with eczema will have improved by their teenage years.
Pompholyx eczema is a variant which affects the hands and feet and is characterised by small very itchy blisters just under the skin. Other forms of eczema include contact dermatitis.
Treatment is aimed at reducing the frequency and intensity of flares and includes the regular and liberal use of moisturisers, avoidance of soaps and fragranced products and use of soap substitutes. Studies have shown that the regular use of moisturisers can reduce the need for topical steroids. However, during flares topical steroids are a safe and effective treatment when used correctly. Side effects arise from the prolonged use of potent steroids.
Alternative non-steroid, topical treatments are Protopic (topical tacrolimus) and Elidel (pimecrolimus). Protopic can cause a burning sensation on initial use and may result in mild flushing with alcohol consumption but can be an effective alternative to topical steroids.
For more severe cases of eczema, that don't respond to topical treatments, other forms of treatment include light therapy or immunosuppressive drugs such as steroid tablets, ciclosporin, methotrexate, mycophenylate mofetil and azathioprine.
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Over the last six years a number of new medications have been developed to specifically treat eczema. Dupilimumab, was the first monoclonal antibody approved for the treatment of eczema in the UK in 2018. Jannus Kinase (JAK) inhibitors eg Baricitanib is also approved to treat eczema. Other treatments are undergoing clinical trials.